Active NPI
Judith Helene Brohman, MA LLP
- Clinical Psychologist
- Southgate, MI
National Provider Identifier
1972767010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301008515
- Practice address
- 19291 Northline Rd
Southgate, MI 48195-2220 - Phone
- (734) 287-1500
- NPI assigned
- Jul 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301008515 | MI | Primary |
Addresses
Primary practice location
19291 Northline Rd
Southgate, MI 48195-2220
Mailing address
19291 Northline Rd
Southgate, MI 48195-2220
Phone (734) 287-1500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301008515 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216252800000",
"number": "1972767010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19291 NORTHLINE RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481952220",
"telephone_number": "734-287-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19291 NORTHLINE RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481952220",
"telephone_number": "734-287-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROHMAN",
"first_name": "JUDITH",
"middle_name": "HELENE",
"name_prefix": "Ms.",
"credential": "MA LLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-17",
"last_updated": "2008-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301008515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southgate, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.